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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study presents the results of a needs assessment survey conducted with 66 incarcerated women in a large Philadelphia county jail during the winter of 1993. Results indicated that prior to incarceration, these women engaged in very high risk sexual and drug use behaviors, and had experienced a myriad of other problems that may contribute to their risk for HIV infection. Of the 66 women who participated in the study, over three-fourths had used crack cocaine, nearly one-half had traded sex for drugs and money in the six months prior to incarceration, one-third reported a prior history of injection drug use, and one-half report sexual contact with a male partner who injected drugs. In addition, one-fourth of the study sample had been homeless during the year prior to incarceration, one-half reported a prior history of sexual abuse, three-fourths had been physically beaten by a boyfriend or spouse, and nearly one-half had a prior history of syphilis. Although limited in scope, the results of the study have important implications for developing relevant jail-based HIV risk reduction programs for women. The results provide strong evidence for the need for interventions that address not only the HIV-related risk behaviors of incarcerated women, but also the underlying social problems that contribute to their risk of HIV infection.
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PMID:At risk for HIV infection: incarcerated women in a county jail in Philadelphia. 910 63

Of 327 homosexual and bisexual men participating in an ongoing cohort study pertaining to risk factors for HIV infection who completed a survey regarding history of sexual abuse, 116 (35.5%) reported being sexually abused as children. Those abused were more likely to have more lifetime male partners, to report more childhood stress, to have lied in the past in order to have sex, and to have had unprotected receptive anal intercourse in the past 6 months (odds ratio 2.13; 95% confidence interval 1.15-3.95). Sexual abuse remained a significant predictor of unprotected receptive anal intercourse in a logistic model adjusting for potential confounding variables.
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PMID:Childhood sexual abuse among homosexual men. Prevalence and association with unsafe sex. 912 31

The objective of this study is to describe the characteristics associated with a history of sexual abuse among HIV-infected women enrolled in a public inner-city HIV outpatient clinic. A retrospective chart review of 238 women of childbearing age enrolled in the HIV outpatient clinic between 1987 and 1995 was performed. Characteristics of the study population were 83% African American, 69% single, and 53% finished high school or were still in school. The mean age was 25.7 years. Of the 238 women, 32% had a history of sexual abuse. Factors associated with sexual abuse history after controlling for age included living in a non-permanent situation (OR=4.8), history of non-intravenous drug use (OR=4.65), and having dropped out of school (OR=2.2). HIV-infected women should be screened for a history of sexual abuse and carefully counselled regarding their reproductive choices and drug treatment.
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PMID:History of sexual abuse among HIV-infected women. 917 57

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.
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PMID:Homeless youths and young adults in Los Angeles: prevalence of mental health problems and the relationship between mental health and substance abuse disorders. 933 67

An emerging body of research on the physical and sexual abuse of seriously mentally ill (SMI) women documents a high incidence and prevalence of victimization within this population. While causal links are not well understood, there is convergent evidence that victimization of SMI women is associated with increased symptom levels, HIV-related risk behaviors, and such comorbid conditions as homelessness and substance abuse. These abuse correlates may influence chronicity, service utilization patterns, and treatment alliance. This article reviews the research literature on the prevalence, symptomatic and behavioral correlates, and treatment of abuse among SMI women, particularly women with schizophrenia. Within each topic, we discuss relevant research findings, limitations of available studies, and key questions that remain unanswered. We also discuss mechanisms that may underlie the relationship between trauma and schizophrenia-spectrum disorders. We conclude by outlining directions for future research in this area.
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PMID:Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. 936 4

Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had "ever been forced to have sex" as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (AOR = 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of sexual abuse, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.
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PMID:Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada. 948 50

Associations between childhood sexual and physical abuse and HIV-related risky behavior were examined among low-income, urban women with severe mental disorders. Early sexual abuse was found to be related to adult sexual and physical assault, alcohol and cocaine abuse, and prostitution; childhood physical abuse was related to adult physical assault and alcohol abuse. Findings highlight the importance of making HIV risk-reduction programs a part of integrated services that address a full range of psychosocial needs.
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PMID:HIV risk-behavior in poor urban women with serious mental disorders: association with childhood physical and sexual abuse. 949 44

Although the magnitude of child sexual abuse (CSA) in sub-Saharan Africa remains unknown, this problem has become a focus of increasing public concern and outcry. Presented in this article are 4 of the 20 CSA cases treated at the Department of Obstetrics and Gynecology at the University of Malawi Hospital (Blantyre) in a recent 2-year period. The 4 girls, aged 2-7 years, were molested by men 20-70 years old well known to the families. Physical injuries included extensive third-degree perineal tears, lacerations of the lateral vaginal wall and vestibule, bruised labia majora, and torn hymen. In all 4 cases, the caretakers refused to report the assault to the police because of fear of social stigma and the likelihood of a hostile response on the part of authorities. Despite instructions to return to the unit for follow-up, none of the children were seen after their injuries had been treated. Thus, no information is available on long-term medical or psychological sequelae of the abuse. The guardians of 2 of the girls refused to authorize HIV testing; 1 of the 2 tested children had a positive result, but infection may have been acquired prenatally. In 2 cases, the child was living with her grandmother; in the remaining 2, both parents worked in the city and the children were in the care of a houseboy. Continued disintegration of traditional family structures is expected to contribute to increases in the prevalence of CSA in sub-Saharan Africa. Also of concern are cultural practices, such as the belief that sex with a virgin child can cure sexually transmitted diseases or bring riches, as well as a tendency for adult males to attempt to avoid HIV infection through sex with children. Prevention and management of CSA require public awareness campaigns, the design of protocols for the treatment of child victims, guidelines for the management of immediate families and assailants, health personnel training, and enforcement of appropriate legal provisions.
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PMID:Sexual abuse of minors: emerging medical and social problem in Malawi. 955 52

Recent research suggests that sexual abuse may be a potent risk factor for engaging in HIV risk behaviors for women. This relationship is likely mediated by the long term sequelae of sexual abuse. One plausible causal pathway posits that specific social network characteristics increase HIV risk exposure opportunities. This is premised on the belief that previous sexual abuse predisposes some women to become members of risk networks characterized by deviant behaviors and that HIV risk occurs in the context of these networks. One hundred and thirty women opiate users were systematically recruited from methadone maintenance and syringe exchange programs in New York City. The women participated in a one hour interview and provided information on drug use and frequency, HIV drug and sex risk behaviors, social network characteristics, and sexual abuse histories. Univariate and logistic regression techniques were used to test the relationship between sexual abuse and increased HIV risk as mediated by social network characteristics. Previous sexual abuse was strongly related to all social network characteristics examined. Moreover, these network characteristics appeared to affect patterns of drug use in identifiable ways. Social isolation was the only network characteristic associated with both HIV drug and sex risk behaviors. However, although a history of sexual abuse was significantly associated with five of the seven specific HIV risk behaviors examined, the relationship between sexual abuse and HIV risk behaviors remained unchanged when social network characteristics were included in the statistical model. Overall, the results suggest that a sexual abuse experience or its aftermath influence behavior far into the future. However, the results of this study did not show social network characteristics mediating the relationship between sexual abuse and HIV risk. Rather, previous sexual abuse and social network characteristics appear to be independent contributors to HIV risk behaviors for women.
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PMID:Social network characteristics as mediators in the relationship between sexual abuse and HIV risk. 969 Aug 23

Data from a cohort of young HIV-negative gay and bisexual men were analyzed to identify determinants of sexual risk-taking at baseline. Gay/bisexual men aged between 18 and 30 completed a self-administered questionnaire including demographics, depression, social support, substance use, and consensual versus nonconsensual sex. Risk-takers were defined as those who had unprotected anal sex with casual male sex partners in the previous year; non-risk-takers were defined as those who reported consistent condom use during anal sex with all male partners in the previous year. Logistic regression was used to identify independent predictors of sexual risk-taking. Of 439 men studied, risk-takers had less education, a higher depression score, less social support, and were more likely to report nonconsensual sex and recreational drug use relative to non-risk-takers. Independent predictors of sexual risk-taking were low education, nitrite use, low social support (adjusted odds ratio [AOR]=1.65; 95% CI, 1.04-2.59), and nonconsensual sex experienced as a youth or adult (AOR=1.85; 95% CI, 1.15-2.96). Young gay/bisexual men reporting nonconsensual sex, low social support, or nitrite use were significantly more likely to have recently had unprotected anal sex with casual partners. HIV prevention programs aimed at young gay/bisexual men should include sexual abuse counselling and foster community norms supporting safer sex practices.
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PMID:Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. 973 71


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